Ruan Guanyu, Ye Lixiang, Liu Guifen, An Jian, Sehouli Jalid, Sun Pengming
Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University.
Fujian Center for Safety Evaluation of New Drugs, Fujian Medical University.
Onco Targets Ther. 2018 Jan 23;11:521-528. doi: 10.2147/OTT.S155581. eCollection 2018.
The impact of bevacizumab (an anti-vascular endothelial growth factor therapy) remains uncertain, which has been the focus of studies on the management of epithelial ovarian cancer (EOC). To investigate the efficacy of bevacizumab combinations with different regimens in the treatment of patients with EOC, a meta-analysis of Phase III randomized controlled trials was conducted. The databases searched included PubMed, Embase, ClinicalTrials.gov, Chinese Knowledge Infrastructure, as well as the Cochrane Central Register of Controlled Trials. After evaluation of quality, a meta-analysis of valid extracted data was performed using Review Manager (RevMan) software. Five studies with 4,369 patients were included. Bevacizumab plus chemotherapy improved progression-free survival (hazard ratio [HR] =0.63; 95% confidence interval [CI], 0.51-0.77; <0.01) and overall survival (HR =0.91; 95% CI, 0.84-0.99; <0.05). Interestingly, in patients with a high risk of progression, the subgroups that received bevacizumab combined with different regimens of chemotherapy showed a significant improvement with paclitaxel plus carboplatin-based chemotherapy (HR =0.86; 95% CI, 0.77-0.95; <0.01), but not with non-paclitaxel plus carboplatin-based chemotherapy (HR =0.91; 95% CI, 0.77-1.07; >0.05) in overall survival. The combination of bevacizumab and paclitaxel plus carboplatin-based regimens offers a new treatment option for women with EOC, especially in those with a high risk of progression.
贝伐单抗（一种抗血管内皮生长因子疗法）的影响仍不确定，这一直是上皮性卵巢癌（EOC）治疗研究的重点。为了研究贝伐单抗联合不同方案治疗EOC患者的疗效，进行了一项III期随机对照试验的荟萃分析。检索的数据库包括PubMed、Embase、ClinicalTrials.gov、中国知网以及Cochrane对照试验中央注册库。在评估质量后，使用Review Manager（RevMan）软件对有效提取的数据进行荟萃分析。纳入了五项研究，共4369例患者。贝伐单抗联合化疗改善了无进展生存期（风险比[HR]=0.63；95%置信区间[CI]，0.51 - 0.77；<0.01）和总生存期（HR =0.91；95% CI，0.84 - 0.99；<0.05）。有趣的是，在进展风险高的患者中，接受贝伐单抗联合不同化疗方案的亚组在基于紫杉醇加卡铂的化疗中总生存期有显著改善（HR =0.86；95% CI，0.77 - 0.95；<0.01），但在基于非紫杉醇加卡铂的化疗中则没有（HR =0.91；95% CI，0.77 - 1.07；>0.05）。贝伐单抗与基于紫杉醇加卡铂的方案联合为EOC女性患者提供了一种新的治疗选择，尤其是在那些进展风险高的患者中。
